Case report: Acute myocardial infarction complicating a viper bite

Area of Science:

• Cardiology
• Toxicology
• Internal Medicine

Background:

• Myocardial infarction (MI) is a serious cardiac event, typically associated with traditional cardiovascular risk factors.
• Snakebite envenomation is an uncommon cause of MI, with limited documented cases.
• Understanding the pathophysiology of non-atherosclerotic MI is crucial for effective patient management.

Observation:

• A 40-year-old farmer experienced acute myocardial infarction (MI) hours after a snakebite.
• The patient presented with classic chest pain, ECG changes, and elevated cardiac biomarkers (MB-CK).
• Crucially, the patient had no pre-existing coronary artery disease risk factors and normal coronary arteries on angiography.

Findings:

• The case confirms that snakebite can precipitate acute myocardial infarction (MI) in the absence of atherosclerosis.
• The diagnosis of MI was supported by clinical presentation, electrocardiographic findings, and elevated serum MB-CK levels.
• Cardiac catheterization ruled out obstructive coronary artery disease as the cause of the MI.

Implications:

• This case underscores the importance of considering myocardial infarction (MI) in the differential diagnosis of chest pain following snakebite.
• It suggests that venom components may directly or indirectly trigger acute coronary events.
• Further research into the mechanisms of snakebite-induced MI is warranted to improve clinical outcomes.